Patient perception of laparoscopic excision of endometriosis

Cooper MJW, Salmanli N.
Presented at the Australian Gynaecological Endoscopy Society Annual Scientific Meeting.
Adelaide 28th May 1999.

This was a retrospective questionnaire sent to 90 patients at the end of 1998 who had had laparoscopic excision of endometriosis. Forty patients (44%) responded at an average of 14 months following the surgery.

The patients were asked to rate their symptoms as compared to preoperatively (1 = Much worse, 10 = Very much improved). The results are tabled:

1. Pain

Symptom	n	Average score
Pelvic pain	31	8
Dysmenorrhoea	30	8
Backache	26	7
Ovulation pain	25	8
Dyspareunia	24	8
Thigh/leg pain	18	6
Upper abdominal pain	1	9

2 . Bleeding

Symptom	n	Average score
Menorrhagia	29	8
Irregular bleeding	17	8
Premenstrual spotting	15	8

3. Bowel & Bladder symptoms

Symptom	n	Average score
Dyschezia	23	8
Diarrhoea/constipation	20	7
Bleeding from bowel	7	8
Dysuria	6	7
Bowel symptoms	3	5
Bleeding in urine	1	8

4. Other symptoms

Symptom	n	Average score
Bloating	30	7
Depression/irritability	23	7
Premenstrual symptoms	23	7
Lethargy	22	6
Nausea/vomiting	14	7

The mean score for satisfaction with surgery was 8 (ie 80%) and 35 patients indicated they would recommend similar surgery to a friend.

Conclusion

The analysis is subjective and there is potential for bias but nevertheless there appears to be a 70 to 80% chance of symptom relief and this supports the role of excisional techniques in the treatment of endometriosis.

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